|
-
Female sex [49]
-
Older age [49]
-
Unmarried [56]
-
Poor financial status [70]
-
Low educational attainment [10]
-
Lack of health insurance [62]
|
|
|
-
Depression [55]
-
Poor baseline functional status [55][57][62][55,57,62]
-
Pre-treatment fatigue [56]
-
Pre-treatment dyspnoea [56]
-
Poor nutrition [57]
-
Polypharmacy [57]
-
Comorbidities [59]
-
Cognitive impairment [62]
-
Obesity [10]
|
|
| Barthel Index [25] (Basic ADLs) |
|
| Patient-reported or direct observation |
|
| Cancer-related factors |
|
| Treatment-related factors |
| Feeding, toileting, bathing, dressing, and undressing, toilet transfers, incontinence, bed transfers, and ambulation |
|
| Intended for patients with stroke, neuromuscular disorders, musculoskeletal disorders, and cancer. |
|
| Eastern Cooperative Oncology Group Performance Status (ECOG) [26] |
|
| |
|
| Patient-reported |
|
|
-
Chemotherapy [55][56][57][55,56,57]
-
Radiotherapy [52]
-
Surgical complications [63]
-
Readmission after surgical hospitalisation [63]
|
| Percentage of day spent ambulatory or in bed |
|
| 5-point scale, where 0 is “Fully active” and independent and 5 is “Dead”. Commonly used in oncology due to its simplicity [27]. Tends to have minimal direct input from the patient. Noted by the International Society of Geriatric Oncology (SIOG) to be a poor marker of function as functional impairment can occur in the presence of good performance status [28]. |
|
|
| Karnofsky Performance Status Scale (KPS) |
| (Both instrumental and basic ADLs) |
|
| Patient-reported |
|
| Activity, work, self-care |
|
| 10–100-point scale, gold-standard measurement of performance status in cancer. Thorne-modified KPS better suited to community-based and palliative care settings [29], while Australia-modified KPS is better suited to settings with multiple venues of care across both inpatient and outpatient settings [30]. Noted by SIOG to be a poor marker of function as functional impairment can occur in the presence of good performance status [28]. |
|
| Katz Index of Independence in Activities of Daily Living Scale (ADL) [31] |
| (Basic ADLs) |
|
| Patient-reported |
|
| Bathing, dressing, toileting, transferring, continence, and feeding |
|
| Most commonly used instrument in studies assessing activities of daily living in adults with cancer [32]. Shortened versions are often used due to length: modified Katz-1 assesses dressing, bathing, transferring, eating, and toileting, but does not assess continence; modified Katz-2 assesses the original six domains in the Katz ADL scale, as well as walking across a small room [27]. |
|
| Lawton Instrumental Activities of Daily Living Scale (IADL) [33] |
|
| Patient-reported |
|
| Ability to use telephone, shopping, food preparation, housekeeping, laundry, transport, responsibility for medications, and finances |
|
| Second-most commonly used instrument used in studies assessing activities of daily living in adults with cancer [32]. |
|
| Rosow–Breslau Health Scale [33] |
|
| Patient-reported |
|
| Ability to do heavy housework, walk up and down stairs, and walk half a mile |
|
| Simple 3-point scale that can be easily implemented in the clinical setting. Less commonly used in patients with cancer and in oncology research. |
|
| Functional Independence Measure (FIM) [34] |
|
| Direct observation |
|
| Self-care, sphincter control, transfers, locomotion, communication, and social cognition |
|
| Used for evaluation in the rehabilitation of patients post-stroke, traumatic brain injury, spinal cord injury, or cancer. |
|
| Frail Elderly Functional Assessment Questionnaire (FEFA) [35] |
|
| Patient-reported |
|
| Mobility, transfers, housework, meal preparation, finances, telephone use, eating, dressing, personal hygiene, and medication management |
|
| Older, less-widely used tool. Validated against Katz ADL, IADL, and Barthel Index [36]. |
|
| Elderly Functional Index (ELFI) [37] |
|
| Patient-reported |
|
| Physical functioning, role functioning, social functioning, and mobility |
|
| Newer tool derived from functional domains of common quality of life instrument European Organisation for Research and Treatment (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30). Suggested for use as an endpoint of functional status in clinical trials or in clinical practice. |
|
| Physical performance measures |
|
| Grip strength |
|
| Direct observation |
|
| Forearm strength |
|
| Requires a dynamometer for testing. Poorer scores are associated with poorer health-related quality of life [38] and increased mortality [39] in patients with cancer. |
|
| Gait speed [40] |
|
| Direct observation |
|
| Walking speed over a short distance, typically 4, 6, 8, or 10 m |
|
| Poorer scores are associated with decreased survival outcomes and treatment-related complications in cancer survivors [41]. Requires a stopwatch, although electronic gait mats or automatic timing devices provide more accurate assessments [40]. |
|
| 6-Minute Walk Test (6MWT) [17] |
|
| Direct observation |
|
| Aerobic capacity and endurance over six minutes of walking |
|
| Good measure of cardiorespiratory fitness. Validated for use in patients with cancer [42]. Does not require specialised equipment, but does require a stopwatch and a walkway of known length. |
|
| Timed Up and Go Test (TUG) [43] |
|
| Direct observation |
|
| Gait speed and mobility: measures the time taken to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down while turning 180 degrees |
|
| Poorer scores are associated with decreased survival outcomes, treatment-related complications, and functional decline in cancer survivors [41]. Can be used as a substitute measure for gait speed. Does not require specialised equipment. |
|
| Short Physical Performance Battery (SPPB) [44] |
|
| Direct observation |
|
| Lower limb muscle strength, balance, and mobility |
|
| Poorer scores are associated with decreased survival outcomes, treatment-related complications, and functional decline in cancer survivors [41]. Can be used as a substitute measure for gait speed. Does not require specialised equipment. |
|
| Physical Performance Test (PPT) [45] |
|
| Direct observation |
|
| Writing, eating, dressing, grip strength, mobility, dexterity, communication, upper limb function, and balance |
|
| Requires various household items for assessment. Direct comparison with the KPS scale indicates that the PPT is more accurate in measuring functional status in older patients with cancer [46]. |
|